An 81-year-old woman is bought into the accident and emergency department by ambulance from a local nursing home. Yesterday evening, she sustained a mechanical fall, tripping over the walking stick. Despite a small graze to the right side of the head, there was no loss of consciousness and the patient reassured care home staff that she was fine. An incident report was filed. During the night the patient took paracetamol for pain control of a headache but no further action was taken.
In the morning, she complained of the continued headache and the care staff noted a general listlessness and drowsiness. During the course of the day, this progressed, and the patient was found slumped in her chair before lunch, rousable only to strong verbal commands. Staff were worried and called an ambulance. Examination On inspection, the patient had a superficial graze to the right side of her forehead.…
